PHYSIOTHERAPY IN AIDS

DEFINITION
• AIDS (acquired immunodeficiency syndrome) is a
syndrome caused by a virus called HIV (human
immunodeficiency virus).
• The disease alters the immune system, making
people much more vulnerable to infections and
diseases. This susceptibility worsens as the
syndrome progresses.
• HIV is the virus, which attacks the T-cells (CD-4
cells) in the immune system. AIDS is the
syndrome, which appears in the advanced stage
of HIV infection.
 CAUSES
• HIV is a retrovirus that infects the vital organs and cells
of the human immune system.
• The virus progresses in the absence of antiretroviral
therapy (ART) - a drug therapy that slows or prevents
the growth of new HIV viruses.
• The rate of virus progression varies widely between
individuals and depends on many factors;
• These factors include the age of the patient, the body's
ability to defend against HIV, access to healthcare,
existence of other infections, the infected person's
genetic inheritance, resistance to certain strains of HIV,
and more.
 HOW IT IS TRANSMITTED ?
• Sexual transmission - it can happen when there is contact
with infected sexual fluids (rectal, genital, or oral mucous
membranes). This can happen while having unprotected sex,
including vaginal, oral, and anal sex.

• Perinatal transmission - a mother can pass the infection on to

her child during childbirth, pregnancy, and also through
breastfeeding.

• Blood transmission - the risk of transmitting HIV through

blood transfusion is nowadays extremely low in developed
countries. However, among injection or IV drug users, sharing
and reusing syringes contaminated with HIV-infected blood is
extremely hazardous.
 EARLY SYMPTOMS OF HIV INFECTION
• fever
• chills
• joint pain
• muscle aches
• sore throat
• sweats (particularly at night)
• enlarged glands
• a red rash
• tiredness
• weakness
• unintentional weight loss
 ASYMPTOMATIC HIV
• In many cases, after the initial symptoms
disappear, there will not be any further
symptoms for many years.
• During this time, the virus carries on developing
and damaging the immune system and organs.
Without being on medications to stop HIV's
replication, this process can take up to 10 years
on average. The infected person often
experiences no symptoms, feels well, and
appears healthy
 LATE- STAGE HIV INFECTION
• If left untreated, HIV weakens the ability to fight
infection. The person becomes vulnerable to
serious illnesses. This stage of infection is
known as AIDS.
• During late-stage HIV infection, the risk of
developing a life-threatening illness is much
greater. Life-threatening illnesses may be
controlled, avoided and/or treated with proper
medications, often including HIV treatment.
 SYMPTOMS- LAST STAGE
• blurred vision
• diarrhea, which is usually persistent or chronic
• dry cough
• fever of above 100 °F (37 °C) lasting for weeks
• night sweats
• permanent tiredness
• shortness of breath (dyspnea)
• swollen glands lasting for weeks
• unintentional weight loss
• white spots on the tongue or mouth
 DIAGNOSIS
• ELISA Test — ELISA, which stands for enzyme-linked immuno
sorbent assay, is used to detect HIV infection. If an ELISA test is
positive, the Western blot test is usually administered to confirm
the diagnosis. If an ELISA test is negative, you should be tested
again in one to three months.
• Western Blot — This is a very sensitive blood test used to confirm a
positive ELISA test result.
 TREATMENT
• Earlier HIV antiretroviral treatment is crucial - it
improves quality of life, extends life expectancy,
and reduces the risk of transmission, according to
the World Health Organization's guidelines issued
in June 2013.
• Currently, there is no vaccine or cure for HIV, but
treatments have evolved which are much more
effective and better tolerated - they can improve
patients' general health and quality of life
considerably, in as little as one pill per day.
 PT IN ACUTE STAGE
• Physiotherapists are experts in body movements and
exercises that’s why they take a primary role in
treatment of HIV/Aids patients both during acute and
rehabilitation phases. In acute stage Physiotherapists
are involved in the following ways depending on the
presentation of the patient:
 Maintaining the pulmonary system by clearing chest
secretions and expanding lung tissue if there is a
collapse
 Maintaining the normal joint ranges and increasing
circulation to dependant limbs by doing passive
mobilization.
 Postural correction to prevent any deformities.
 PT IN CHRONIC STAGE/ REHABILITATION
STAGE
• Physiotherapists work with all health providers as a team
with Doctors, Nurses, Occupational therapists, and Social
workers only to mention a few.
• The advances in the treatment of HIV have resulted in
increased life expectance in people living with HIV as long as
they have access to the new treatment regime.
• But due to the medicinal or disease effects, the chances of
these people developing disability are very high.
• A wide range of problems are likely arising from
neurological, musculoskeletal and painful syndromes.
• All these problems can be reduced through Physiotherapy
interventions by applying the following depending on the
presentation of the patient;
 CONTD
• Maintaining the normal joint ranges and increasing
circulation to dependant limbs by doing passive
mobilization
• Stretching exercises as a prevention of painful
contractures
• Restoration of body image due to weight loss by
strengthening wasted muscles
• Pain management by using electrotherapy
• Active mobilization through to independent walking
• Provision of assistive device i.e. Crutches, walking sticks
etc
• Health promotion advice
• Postural correction to prevent any deformities
 CONCLUSION
• Patients attending Physiotherapy recover quickly to
independence and are discharged early from the
hospital.
• Inclusion of Physiotherapy services in all HIV/AIDS care
manifesto will prevent development of patient
complications and earlier intervention to those with
complications.
• The saying that prevention is better than cure can be
proved.
• Rehabilitation makes a difference in people living with
HIV by making them active once again and allowing them
to participate in the economy of the nation.